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Hilarious ICD-10 Holiday Parody Video

Posted on December 28, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As most of you know, Nuesoft has a great video team that’s put together some great videos in the past. Most of you will remember the HL7 Interface Lady Gaga video from Nuesoft and for those who don’t know that video, go and watch it. Sometimes we take ourselves too seriously in healthcare and these are some great reminders to keep it lively.

In fact, Nuesoft’s last video was far too formal for me. So much so that I let them know in the comments of the video how disappointing it was to have a formal video when I was use to Nuesoft’s creative masterpieces. I’m happy to report that Nuesoft is back again with a great ICD-10 Holiday parody video. I was laughing through the whole thing and I think you’ll enjoy the video embedded below.

All I Want for Christmas…

Posted on December 24, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

My family and I are in final preparations for Christmas. It’s an exciting time for me. I love everything about the season. I don’t stress over gift giving. I wallow in the joy of getting to spend money on someone I love. I don’t mind the crowds at the mall. I love the hustle, bustle, excitement and energy with everyone running around. Add in some Christmas music that reminds me of many wonderful Christmas’ past. It’s a wonderful time to me.

As I consider Christmas, my two favorite parts of Christmas is giving someone something they’ve always wanted and dreaming of the things that I would love to get for Christmas. So, in that vain, let’s dream about what I’d want for Christmas from an EMR and Healthcare IT perspective.

1. Open EHR Systems – I wish that every healthcare IT system would embrace truly open APIs and that the healthcare data would start flowing. I can only imagine the amazing benefits to healthcare if vendors would just embrace open exchange of healthcare data. It’s the right thing to do and can also be a tremendous business opportunity.

2. Remove Healthcare’s Perverse Incentives – It always pains me to see so many perverse incentives in healthcare. I applaud the many many doctors who do the right thing regardless of the incentive. However, we’d be in a lot better position if we had more than the good nature of doctors driving things. One simple example, can we finally reimburse a doctor for their time spent on an email or video visit on a website? In a large percentage of cases that’s more than sufficient. Yet, the current healthcare incentives “force” a doctor to have you come to the office in order to get paid. That’s perverse and sad.

3. Beautiful EHR User Interfaces – I must acknowledge that we’ve made some real progress on the EHR UI. You should have seen the UI’s we were dealing with when I started blogging 7 years ago. We’re measurably ahead of where we were then. However, with 300+ EHR companies we still have a lot of room to improve the EHR user interface. EHR is the heart of a practice and the better the UI the better the heart. We all know how important a heart is to your health.

4. More Empowered and Trusted Patients – Imagine where the patient was a full participant in their healthcare. That includes being trusted and listened to by their doctor and a patient who thoughtfully considers and listens to their doctor. This is not a one sided issue. This is something that both patients and doctors can improve. There are as many belligerent patients as their are arrogant doctors. We need a good dose of humility, care and trust re infused into healthcare. I think they only way we’ll get there is for the lines of communication to open up on an unprecedented level.

Those are a few of my Christmas wishes. Whether you celebrate Christmas or some other Holiday tradition, I’d love to hear what you’d love to see happen in healthcare. And to those of you who do enjoy Christmas, Merry Christmas!

Rip & Replace EHR, 3rd Party EHR Connections, and EHR Advice from a Physician

Posted on December 23, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


It’s not good for morale, finances, or patient care. Although, it might be better than being stuck with an EHR that is worse for morale, finances and patient care. It’s not an easy decision to switch EHR, but sometimes it’s necessary. Although, this is an almost impossible decision for a hospital. See this post about the “Wrong EHR” conundrum.


I’m not sure how much of this twitter thread will embed. If it doesn’t, then here’s a link to see the full thread. I hope that we can continue to raise the call for more open systems and access to EHR by third party software! Which EHR will set themselves apart in this regard?


Great advice for every doctor when it comes to EMR. It’s a hard shift for many, but I expect Dr. Noah won’t have any issues with this advice.

Most Expensive Purchase is Second EHR

Posted on December 21, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

At an event this fall I happened upon an executive at one of the major EHR vendors. We had a brief discussion in the lobby, but he said something that I found really interesting and I think describes the strategy of many of the large ambulatory EHR vendors. Here’s what he said:

“The Most Expensive Purchase is Their Second EHR”

A popular EHR consultant was in on the conversation and he started shaking his head in agreement.

I’ve long suggested that practices usually get their second EHR selection and implementation right. It just makes common sense that a practice would use the lessons learned from their first EHR implementation and be able to do a better job selecting and implementing the second EHR implementation. Although, I have heard of cases where it took the third implementation to do it right.

What intrigued me more was that this EHR vendor executive tied the purchase price to a second EHR. He’s right that price becomes a very different discussion when you are talking to someone who is buying their second EHR. In a lot of cases, price becomes a non-issue for those implementing their second EHR. They will spend whatever amount is needed to be able to get an EHR that they like to use. This is reflected in the quote above. I expect that’s why a second EHR is the most expensive purchase.

I wonder how many EHR companies are capitalizing on this fact. I’ve heard from numerous people that there’s a lot of EHR switching that’s happening right now. So, the idea of a second EHR is not outlandish. For many, the second EHR implementation has become a major reality.

The Fiscal Cliff of Primary Care

Posted on December 20, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The Hello Health blog has a really interesting article up discussing what they called the Primary Care Fiscal Cliff. The thing I like most about the post is the data they provide on what’s happening with primary care doctors. Take for example this list of statistics:

  • Primary care practice income rose just $500 from 2008-2011
  • Operating expenses of a practice continues to rise each year
  • Primary care physicians can spend an average of 13 hours a week of uncompensated care worth over $30,000 in lost revenue a year
  • The cost of a traditional electronic health record can easily exceed $20,000 in the first year with a 5-year projected cost approaching $50,000 per physician

I’m not sure that the US government’s fiscal cliff has much relationship to the primary care doctor fiscal cliff (except for the possible Medicare cuts), but it’s very safe to say that primary care doctors are in a real financial predicament.

In the Hello Health post they suggested from their own research that practice finances and EHR are the two issues keeping primary care physicians up at night. I’m sure these findings won’t be a surprise to any primary care doctors. Plus, it’s worth noting that the finances of a primary care practice are tied to an EHR in many ways.

I have often questioned how much influence the government EHR incentive money has had on getting doctors to adopt EHR. Whenever I do, I usually get a response from a primary care doctor saying that they wouldn’t be implementing an EHR if it weren’t for the EHR incentive money and that they were depending on the EHR incentive money to help cover the new EHR expense.

In my recently started EHR benefit series I’m hoping to expand the thinking when it comes to EHR revenue implications. There are still tens of thousands of primary care doctors that need to implement an EHR or replace their existing EMR. Understanding the financial ties to EHR will help a practice ensure a more successful EHR implementation.

At the core of the question is whether EHR software is a financial benefit or a financial loss. The cop out answer to that question is that it depends on how you implement the EHR and which EHR you implement. I wish someone would take the time to study the top 20 EHR companies and evaluate how practices have done pre-EHR implementation and post EHR implementation. Plus, they’d need to take into account the cost of an EHR. That type of study would produce a lot of interesting EHR data.

My gut feeling having participated in numerous EHR implementations and heard from thousands of other EHR implementations is that the result is usually a wash. In most EHR implementations I don’t think there’s a net financial gain or loss. There are outliers on both sides of that spectrum, but I think for most it has some pros and some cons.

With that said, I think there are long term benefits to a practice that has an EHR. While the immediate financial returns may not come, I think that the EHR in a practice is going to be essential for many of the financial gains a practice wants to achieve in the future. The most obvious example is becoming part of an ACO. Can you really get the financial benefits of being in an ACO without an EHR? I think the answer will likely be no. You need the EHR data to obtain and report on the ACO improvements your practice achieves.

Mobile Health Trends and Technology

Posted on December 19, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While at the mHealth Summit 2012 in DC, I captured a couple videos to try and get an idea of the various mHealth trends that we’ve been seeing in 2012 and what we can expect from mobile health in 2013. Each video is quite short, but full of interesting thoughts on the mHealth industry.

The first two videos are with David Collins from mHIMSS. David has a unique insight since HIMSS has made a big entry into the mHealth space with their acquisition of the mHealth Summit.

In the first video, David Collins talks about the various mobile health trends he’s seen at the mHealth Summit.

In this second video, David Collins discusses some of the key findings from the recently published HIMSS Analytics mHealth survey results.

I also thought it was interesting to hear from Jonathon Dreyer from Nuance Communications to learn what trends he was seeing. Jonathon and Nuance have an interesting perspective since so many mHealth applications could benefit from voice integration. So, they have a unique view at what mHealth applications exist.

Plus, I have to throw in this video that Jonathon made that demonstrates the Nuance voice integration with mobile devices. Nuance actually created this “dummy” EMR system to demonstrate the capabilities of their mobile voice recognition API. I think this was a really smart move since the demo really does illustrate some of the voice capabilities that could be built into EMR software and all sorts of mobile health applications. The video isn’t the perfect demo of the product, but it definitely does give a great window on what could be done with voice recognition when integrated properly.

EHR Vendor as ACO

Posted on December 18, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

When I was doing my interview with Dr. Jonathan Bertman and John Mooney about the Pri-Med acquisition of Amazing Charts, Jonathan Bertman made a really interesting comment that stuck with me. I asked him how he thought that Amazing Charts would do in this world of hospitals acquiring medical practices. He said that they were evaluated the environment, but then he suggested something that I’d never heard suggested before.

He said that he was considering the idea of whether Amazing Charts could act as an ACO for its members. You could tell that this was an idea that hadn’t been fleshed out completely. Although, I found it a concept that was really interesting to consider. Could an EHR vendor act as an ACO for the doctors that use their EHR?

The key question to me is really whether an EHR vendor has enough adoption of their EHR in a given area to be able to create an ACO. I imagine an EHR vendor like MEDENT that has only focused on selling their EHR in about 5 states could have enough geographically focused EHR adoption to be able to support the ACO model.

I’ve heard a number of small practice doctors call their colleagues to action when it comes to ACOs. Their call usually includes a reminder to the days of HMO’s when they claimed that doctors weren’t part of the conversation and that they can’t let the same thing happen with ACOs. Could an EHR vendor help to bring all these small practices to the ACO bargaining table? Seems like an interesting idea worth exploring to me.

NBA Implements Cerner EHR – NFL Implements eCW

Posted on December 17, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Over the past couple weeks, a number of major athletic organizations have announced that they’re standardizing their healthcare documentation using EHR software. The NBA is using Cerner’s EHR and the NFL is using eCW’s EHR.

At first blush these announcements remind me of Walmart selling eCW at Sam’s Club and Costco selling Allscripts EHR. Everyone wondered why Costco and Sam’s Club were selling EHR. The obvious answer was that it was a great PR move by eCW and Allscripts. Although, I did hear about one doctor that hijacked an EHR selection process thanks to a Costco mailing. I think that’s the exception.

While big popular sports organizations like the NBA and eCW might be great PR for a company, it is really interesting to consider the unique healthcare needs of a sports league. The first thing that came to my mind was actually whether the teams would want to have their athletes’ health data on one platform. Often, the health of their players is part of their strategic advantage. Certainly there are a lot more rules about disclosure of injuries, but teams still play the injury card before games, in trades, and when signing new players. I imagine the staff doctors for the teams have to be careful how and what they document in the EHR if it’s going to be available to other teams. And we thought privacy was an issue in general EHR use. It’s much more complicated when you have millions of dollars riding on a player.

From a big data perspective, I’m interested to see if either of these leagues will be able to leverage the EHR data they collect in order to deal with the long term health issues of players. This is particularly true in the physically brutal NFL. I’m sure readers are familiar with the long term concussion questions and research that’s happening with the NFL. Not to mention the ongoing battle against the use of steroids and other performance enhancing drugs. Can a unified EHR help to provide a basis for research and understanding of the health consequences of playing in the NFL?

When I start to think about all the medical devices that are coming out, they’re really interesting in an NFL context as well. Imagine all the health data from various devices being sucked into the league’s EHR. When I talked with FitLinxx at the mHealth Summit, they said that the Boston Red Sox used their activity tracking device the year they won the World Series (Seems like Boston might want to consider using it again). From what they described, The Pebble (their activity tracking device) was a great way for the trainer to keep track of compliance with the fitness regiment they suggested. Should this data be in the league’s EHR? I can see health reasons to do so, but it does go back to the question of teams’ competitive advantages.

I bet device makers would love to compare professional athlete’s use of their devices against all of the other data that’s being collected by regular users. Would make for some pretty compelling charts if I could compare my health indicators against Lebron James or Peyton Manning.

What’s also interesting to consider about a major sports league using an EHR is a connected PHR. In these situations you want your players to be well connected to the doctor and you have a real financial interest in their compliance with doctors orders. PHR in this case could make a lot of sense. Although, I wonder if many prima donna athletes would balk at the idea. Well, at least they can have their agent or assistan log in for them.

I do wonder what special features Cerner and eCW were asked to do for the NFL and NBA. Of course, not much of it would likely be useful for the rest of us.

An Example of EHR as Database of Healthcare

Posted on December 13, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of my favorite interviews at mHealth Summit was with Alan Portela, CEO of AirStrip Technologies. I’d definitely heard good things about AirStrip, but I must admit that before our meeting I didn’t have a very good understanding of what AirStrip was really all about. I was pleased to learn that they are well deserving of the hype. I believe AirStrip will do wonderful things to help make healthcare data mobile and AirStrip is lucky to have Alan Portela leading the company. Alan is unique when it comes to healthcare IT leaders in that he understands the healthcare culture, but also has a unique vision for how healthcare can embrace the future.

The core of what AirStrip has done to date has been in OB and Cardiology. In fact, each of those areas is worthy of their own post and look into how they’ve changed the game in both of those areas. The OB side speaks to me since we recently had our fourth child. I can imagine how much better the workflow would have been had my wife’s OB had access to the fetal waveforms (CTGs) on her mobile device. Instead, it was left to the nurse to interpret the recordings and communicate them to the OB. There’s real power for an OB to have the data in the palm of their hand.

Similar concepts can be applied to cardiology. Timing is so huge when it comes to the heart and there’s little doubt that mobile access to healthcare data for a cardiologists can save a lot of time from when the data is collected to when the cardiologist interprets the results.

The real question is why did it take so long for someone like AirStrip to make this data mobile. The answer has many complexities, but it turns out that ensuring that the data displays to clinical grade quality is not as easy as one might think. An ECG waveform needs to be much more precise than a graph of steps taken.

While both of these areas are quite interesting, since I’m so embedded in the EHR world I was particularly interested in AirStrip’s move into making EHR data mobile. They’ve started with Meaningful Use Tracker, but based on my conversation with Alan Portela this is just the beginning. AirStrip wants to make your important clinical information mobile.

I pushed Alan on how he’ll be able to do this since so many EHR companies have created big barriers to being able to access their data. Turns out that Alan seems to share my view that EHR is the Database of Healthcare. This idea means that instead of the EHR doing everything for everyone, a whole ecosystem of companies are going to build amazingly advanced functionality on the back of the EHR data and functions.

In AirStrip’s case, they want to take EHR data and make it mobile. They don’t want to store the data. They don’t want to do the advanced clinical decision support. Instead, they want to leverage the EHR data and EHR functionality on a mobile device.

One key to this approach is that AirStrip wants to be able to do this for an organization regardless of which EHR you use on the backend. In fact, Alan argues that most hospital organizations are going to have multiple EHR systems under their purview. As hospitals continue to consolidate you can easily see how one organization is going to have a couple hospitals on Epic, a couple on Cerner, a couple on Meditech, etc. If AirStrip can be the consistent mobile front end for all of the major EHR companies, that’s a powerful value proposition for any hospital organization.

Of course, we’ll see if AirStrip gets that far. Right now they’re taking a smart approach to mobilizing specific clinical data elements. Although, don’t be surprised when they work to mobilize all of an organization’s healthcare data.

AirStrip is just one example of a company that’s using EHR as their database of healthcare data. I’m sure we’re going to see hundreds and thousands of companies who build powerful applications on the back of EHR data.

EHR Benefit – Legibility of Notes

Posted on December 12, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve hinted for a little while that I was going to start a series of posts talking about the various benefits of using an EHR. I think this is an important subject worth discussing in greater detail. I hope that this series of posts will also help us move past meaningful use of an EHR for the government EHR money and explore all the other reasons why healthcare should fully adopt an EHR.

Back when I first started blogging about EMR software (It was 2005, before the term EHR came to be), I made this list of EMR and EHR benefits over paper charts. I’ll be using that list as the starting point for this series of EHR Benefit posts. I love the first paragraph on that page (which I likely haven’t touched since 2005):

This list is just a starting point to list off all the possible benefits of having an EMR or EHR. Probably a poor one, but a start nonetheless. My plan is for this list to grow over time as I think of new benefits or as people suggest things I’ve most certainly missed. Also, I think that most people often focus too much on the financial benefits of an EMR and so hopefully this list will include financial and other benefits beyond the financial implications.

The list definitely did grow, but I guess I never got around to updating the intro paragraph. Although, I am pleased to see that even back in 2005 I was as interested in the non-financial benefits of EHR. Certainly the financial benefits of EHR are incredibly important, but far too many people don’t take into account the other non-financial benefits in their analysis of EHR benefits. It’s just too hard for many to try and compare or put a value on the non-financial benefits of EHR. We’ll try to point these benefits out just the same.

Now for the first EHR benefit on the list:

Legibility of Notes
I’m really glad to start with an EHR benefit that everyone can understand with little explanation. Poor medical handwriting has been a running challenge in healthcare for as long as we’ve been documenting patient visits. I did a quick search on Google for “write like a doctor” and it had about 321 million results. That’s quite pervasive.

I can’t think of anyone that would argue that healthcare doesn’t have a challenge reading physician’s handwriting. No doubt there are plenty of exceptions to this, but even those with beautiful handwriting still have to read other doctors’ handwriting from their own office or from other doctors’ notes that get sent to their office. It’s great to have the notes, but if you can’t read them then what’s the point.

While certainly illegible handwriting is a major problem in the office, it also extends outside the office as well. Think of all the times pharmacists have had to call a doctor to clarify the prescription a patient brought in. Even worse than that is the number of times the pharmacist misread a script because a doctor’s handwriting is illegible. This becomes a non-issue in an electronic world where the prescription is either printed or ePrescribed.

Of course, none of this is new territory. Every doctor understands these benefits better than I’ve explained here. However, far too often when we think about implementing an EHR, we forget about these simple and easy to understand benefits. How much time is saved in your clinic by being able to read the handwriting in the chart? How much time is saved in healthcare when referrals come in an easy to read, legible format? How much time and how many lives are saved by pharmacists getting the proper prescription to the patient? All of these are hard measures to quantify, but they are real, tangible benefits of an EHR.

I won’t mislead you into thinking the shift from paper charts to EHR solves all the legibility problems. Many template driven EHR software that creates a mass of mostly irrelevant data can be just as hard to decipher as the hieroglyphic handwriting of some doctors. However, I’ve seen a tidal wave of push back against these documentation approaches and I think we’re getting better. I think the shift to quality of care reimbursement versus procedure based reimbursement will help this to go away as well.

There are other things a clinic leaves behind with paper charts. I’ve heard many tell me how many times they looked at the handwriting to recognize who had documented something in a paper chart. Certainly that same info is available in an EHR, but you do lose the instant recognition of who charted what in the chart.

Despite not being able to put a nice dollar value on the Legibility of Notes, it’s certainly an EHR benefit that can’t be forgotten. It’s very easy to adopt an EHR and take this for granted.